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� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� � a, �- (' ��.,r,� �►ve ��,�, �� 5 G�� <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />��%�{t1i�14.1 �l[''i;�ij'� I�.L'�'?�'� � ��Sa <br />Idaii Address <br />\C f�ti� <br />ht�il Addmss <br />� V('tY`��/ �1� ( 1 ���I f>G� d' ( ( <br />Eleclrical Conirector <br />State License Nuniber <br />Proposed Use of Puildinc� <br />Mail Address <br />Descriplion of Work to Be Done: �`'� <br />� (� �-t fi II �1/ <br />Ci�y <br />;��< <��"ov� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />City <br />St3te/Zip <br />City State2ip <br />G C, �od <br />Conlract Price of Work <br />Conlacl Person (Plan Revie�v) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily thaf I have read and examined this applicalion and kno�v fhe sarne fo be true and <br />correcf. All provisions o( Imvs and ordinances c�oveming fhis type ol work will be comp/eferi <br />wf�e0ier speafied herein or noL TOe gran(ing oI a pernuf does not resume fo give aufhonty to <br />violate or cancel the provisions oI any other sfafe orlocal law reguPfin� consfruction or the <br />perionnance o/ construction. That 1 am aufhorized by Ihe ou�ner o( this property lo perfomi fhe <br />work /or �vhich applicafion is made and 1 comp/y wifh Ihe State Contractors La�v 18.27 RCW and <br />296.200 WAC/ <br />i � <br />�,c., -� � �' / / 7—i I'C'r% <br />cl,��� . . � . .. n��� <br />FEE <br />EU�U`�-G7Z <br />Phone <br />Phone <br />; -')4 2- <br />Phone <br />